Lung cancer is the most important cause for cancer death globally,and it ranks the first position in morbidity and mortality among all malignances in China.non small cell lung cancer(NSCLC)accounts for approximately 80% of all lung cancinoma.Surgical resection is the major treatment method for early stage NSCLC.Video-assisted thoracic surgery(VATS) is becoming the preferred surgical procedure for early stage NSCLC,because of it's minimally invasive features.However,controversy remains regarding the extent of lymph node dissection and the completeness of the lymphnode dissection by VATS for early stage NSCLC.This article is a brief review concerning this two questions.

OBJECTIVE: To explore the therapeutic window concentration of tacrolimus(FK506) suitable for Chinese renal transplant recipients. METHODS: The whole blood valley concentration level in 56 renal transplant recipients 12h after oral administration with FK506 was determined by MEIA (Microparticle Enzyme Immunization). The rejections and the renal toxic reaction were observed as well. RESULTS: The recommended therapeutic window concentration of FK506 for Chinese renal transplant recipients were the following: 9～14?g/L during the first month; 8～12?g/L during the second to the third month; 6～10?g/L during the fourth to the sixth month; 4～6?g/L during the seventh to the twelfth month. CONCLUSION: FK506 has a satisfactory immune suppression effect while reducing incidences of rejections and renal toxic reactions if used within the above therapeutic window concentration.

OBJECTIVE:To study the therapeutic window of peak blood concentration at different time in domestic renal transplant recipients2h after administration with cyclosporine A(CsA).METHODS:The valley bottom levels(C 0 )and the peak levels(C 2 )were determined simultaneously by fluorescence polarization immunoassay(FPIA)in92patients2h after oral administration with CsA,the rejection and the hepatic and renal drug toxicities were observed.RESULTS:The recommended therapeutic window concentration of CsA(C 2 )in Chinese renal transplant recipients was1000～1300?g/L within the first month,950～1250?g/L within the second to third month,900～1100?g/L within the fourth to sixth month,750～1000?g/L within the seventh to twelfth month,600～800?g/L from the twelfth month after renal transplantation.CONCLUSION:Within the above therapeutic window concentration range,CsA is of ideal immuno-suppressive action meanwhile it can less rejection and minimize the hepatic and renal drug toxicities.

0.05), respectively; the costs were 640.50yuan and 1 151.21yuan, respectively; the cost-effectiveness ratios were 7.01 and 12.28, respectively; the incremental cost-effectiveness ratio of Group B versus Group A was 220.1. CONCLUSION: The sequential therapy of levofloxacin is preferable in the treatment of lower respiratory infection.

0.05),the toxi?cation rate of the low dose group was lower than that of the routine group(P0.05),the effective concentration of the low dose digoxin group was significantly lower than the routine group(P

Objective To investigate the drug sensitivity and distribution of main pathogenic pathogens in hospitalized patients with respiratory hospital diabetes bacteria and provide reference for the prevention and treatment of diabetes mellitus in experimental infection in patients with respiratory hospital.Methods 69 cases of diabetes mellitus complicated with respiratory infection were selected, their clinical data ( laboratory, imaging and etiological examination data) were complete,and their intact specimens for testing and identificated were throat swabs, sputum smear, sputum culture, protected specimen brush sampling, pathogens culture, and drug susceptibility test of pathogenic bacteria were isolated from the statistical data of 69 patients and prognosis.Results 69 strains of pathogenic bacteria were isolated, identified and isolated from the specimens of all the patients in the study.Among them, there were a total of 86 strains of pathogenic bacteria, including gram positive bacteria (46 strains), gram negative bacteria (27 strains) and fungi (13 strains) .Staphylococcus aureus, Streptococcus pneumoniae, Staphylococcus epidermidis to teicoplanin, clindamycin, amoxicillin and levofloxacin sensitive rate is less than 50%, while to oxacillin, vancomycin, linezolid, ampicillin, imipenem, moxifloxacin susceptibility rate >50%.Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae to ceftriaxone, ceftazidime, amoxicillin, amikacin drug sensitivity of less than 50% of cefoxitin, piperacillin/tazobactam, cotrimoxazole, imipenem, meropenem, netilmicin susceptibility rate >50%.69 patients were diagnosed before treatment with antiviral drugs, antibiotics, antibiotics adjusted according to the etiology and drug sensitivity test results and antiviral drugs, improved in 49 cases of patients to the hospital treatment of 14 cases, 6 cases were converted to sepsis after rescue invalid death.Conclusion The diabetic patients hospitalized in respiratory pathogens of nosocomial infection in a wide range of pathogen susceptibility differences , understand the distribution of pathogens in patients with regular and drug resistance, provide guidance for the prevention and treatment experience, reduce the infection rate of patients with respiratory infection in patients with hospital provided treatment of high pertinence has important significance.

This study sought to detect the pathological changes of anterior cruciate ligament (ACL) and medial collateral ligament (MCL) under injury stretch. Bone-ACL-Bone (B-ACL-B) and B-MCL-B complexes were isolated from 20 male Wister rats, and were immersed in phosphate buffered saline. The complexes were stretched with 10% or 20% strain for 10 min or 30 min. After being stretched, the specimens were fixed in 10% buffered formalin, then mounted in paraffin. Sections were stained with Alcian blue-PAS and HE. The following results were found: In the control group, the matrix in ACL contained much more GAGs, as compared with that in MCL. When stretched with 10%, most of the fibroblasts in ACL were elongated like spindles in shape, and some pyknotic nuclei were found increased with stretching time. With 20% strain, ACL showed disruption in parts of collagen fibrils and lysis. But MCL was often torn at its tibia end. The injury can be detected in pathological slices under microscope, even this injury can not be found with naked eye. This injury first starts with the disturbance of the nucleus in the ligament, but following further stretching, it will extend to the rupture of collagen fibrils, and the serious injury of the fibroblasts is especially bad to the repair of the ligament.
Animals ; Anterior Cruciate Ligament ; pathology ; Anterior Cruciate Ligament Injuries ; Male ; Medial Collateral Ligament, Knee ; injuries ; pathology ; Rats ; Rats, Wistar ; Stress, Mechanical

Postoperative bronchopulmonary fistula(BPF) in lung cancer is an abnormal pathway formed by the bronchus communicating with the pleural cavity after pneumonectomy. Although surgical techniques and perioperative management have been improved, BPF is still a therapeutic challenges to thoracic surgeons. The treatment methods mainly include conservative treatment, surgical treatment and endoscopic interventional therapy. Among them, endoscopic interventional therapy is more and more widely used due to its minimally invasive characteristics, and has achieved a good therapeutic effect. This article reviews the endoscopic interventional treatment of BPF after pneumonectomy and hopes to provide some assistance for treatment of BPF.

Summary: The effects of NO-Fluvastatin on proliferation of human lens epithelial cells (HLECs) and the action mechanism were investigated. Cell proliferation was assessed by MTT assay. Cell cycle was analyzed by flow cytometry. The expression of cell cycle regulatory proteins CyclinE mRNA and P21wafl mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR). MTT staining colorimetry showed that HLECs proliferation was markedly inhibited by NO-Fluvastatin and the effect was dependently related to time (24, 48 and 72 h) and dosage (1, 5 and 20 μmol/L). Flow cytometry revealed that NO-Fluvastatin could significantly block HLECs in the G0/G1 phase, resulting in the increased cells in the G0G1 phase and decreased in the S phase (P<0.05). RT-PCR showed that NO-Fluvastatin could obviously inhibit the CyclinE mRNA expression and induce the P21wafl mRNA expression as compared with the negative control groups (P<0.05). This experiment suggested that NO-Fluvastatin could suppress the proliferation of HLECs by regulating cell cycle regulatory proteins (inhibiting the expression of CyclinE mRNA and inducing the expression of P21wafl mRNA), resulting in the arrest of HLECs in the G0/G1 phase, which can offer theory basis for NO-Fluvastatin in treating posterior capsular opacification in clinic practice.

Objective To compare the anesthetic effect and safety of Ciprofol and Propofol combined with Fentanyl in painless bronchoscopy for conscious patients in intensive care unit(ICU).Methods 60 conscious patients who underwent painless bronchoscopy from October 2022 to January 2023 were selected.According to the random number table method,30 cases were divided into the control group(Propofol 1.5 mg/kg + Fentanyl 1 μg/kg)and 30 cases were divided into the experimental group(Ciprofol 0.4 mg/kg + Fentanyl 1 μg/kg).Systolic blood pressure,diastolic blood pressure,heart rate,respiratory frequency,and percutaneous arterial oxygen saturation(SpO2)were recorded before anesthesia(T1),during the examination(T2),and at the completion of the examination(T3)in the two groups,and the success rate of induction of general anesthesia,the time of induction of anesthesia,the time of bronchoscopy,the time of eye-opening,the total dosage of medications used,the incidence of injection pain,and the incidence of intraoperative adverse reactions(hypotension,respiratory depression,bradycardia,and bucking)in the two groups were compared.Results Analysis of the data revealed significant group,time,and interaction effects for systolic blood pressure,diastolic blood pressure,heart rate,and respiratory frequency at different time points(P<0.05).The experimental group had a shorter induction time of anesthesia[1.40(1.10,1.62)min]in comparison to the control group[1.60(1.30,2.10)min](P<0.05),and the experimental group required a less amount of drug to achieve the desired outcome[(21.40±1.82)mg]compared to the control group[(78.75±6.71)mg](P<0.05).Furthermore,the incidence of injection pain(3.33%)and respiratory depression(6.67%)was significantly reduced in the experimental group compared to the control group(36.67%)and(30.00%)(P<0.05).Conclusion The use of Ciprofol in combination with Fentanyl has been found to provide effective anesthesia during bronchoscopy,while also increasing safety and decreasing the incidence of adverse events.It is worthy of clinical application.